Evaluation of brain parenchyma in paediatric patients diagnosed with poorly controlled type 1 diabetes using volumetric magnetic resonance imaging (MRI).

AIM: To quantitatively assess brain volume changes in response to glycaemic excursions in paediatric patients with poorly controlled type 1 diabetes using software programs from magnetic resonance imaging (MRI).

MATERIALS AND

METHODS

This study included 46 children (24 boys and 22 girls) aged 11-17 years with type 1 diabetes mellitus (T1 DM) diagnosed between February 1, 2014, and February 1, 2023, at our hospital. All patients had a diabetes diagnosis for at least 5 years and available brain MRI data. Brain imaging was performed using a 1.5 Tesla MRI machine (Siemens Magnetom Aera, Erlangen, Germany). Volumetric analysis of 3D T1 Magnetization Prepared Rapid Gradient Echo (MP-RAGE) images was conducted retrospectively using the vol2brain software.

RESULTS

Volumetric analysis using the vol2brain software revealed statistically significant atrophy in the nearly whole brain structures, especially in frontoparietal lobes and basal ganglia compared to the control group. Cerebral cortical thinning was observed globally, with more marked reduction in the insular and temporo-parieto-occipital regions. Among patients with basal ganglia involvement, the hippocampus and nucleus caudatus were the most affected structures. Of all groups, girls aged 15 and 17 were the most affected.

CONCLUSION

In diabetes, micro-level brain parenchymal changes that cannot be detected using conventional methods can be identified through software programs. These findings emphasise the importance of advanced imaging techniques in monitoring cerebral complications in diabetic patients.